Sexual and Gender Identity Disorder

According to Victoria J. et al (2007), Gender Identity Disorder can simply be defined as a “disorder in which someone feels that they are or should be a member of the opposite sex.” American Psychiatric Association, (2000) defines Gender Identity Disorder as a “strong and persistent cross gender identification accompanied by persistent discomfort with ones assigned sex.” It is simply a conflict between what gender one identifies himself or herself with and his or her real gender. An example would be where a certain boy identifies herself as a girl and behaves as such.

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This is a subject that has received immense attention from psychiatrists and psychologists with immense literature written on the same. The interest of this paper will be on the description of the illness as well as the research that exists regarding the disorder. It will also focus on the direction of future research.

Intensified interest into the Sexual and Gender Identity Disorder began over 20 years ago, since then a couple of diagnostic models have been formulated with each spelling out its particular requirements to be met for an inpidual to be fully diagnosed as suffering from the disorder. These would range from a criteria set by Rosen et al (1977) that requires that there be a clear difference between “gender behavior disturbance and cross gender identification” for a full diagnosis to be carried out.

Stoller (1968) referred to the disorder as a male childhood homosexualism which merely in a man is “a fixed belief that he is a member of the opposite sex and will grow up to develop the anatomical characteristics of the opposite sex.” This paper will use the Diagnostic and Statistical Manual of Mental Disorder for diagnosis and the general description of the disorder.

The American Psychiatric Association has spelt out 4 criteria that have to be met for there to be a full diagnosis of the Sexual and Gender Identity Disorder.

The first criterion has it that an inpidual must manifests an acute problem of cross- gender identification. This is where there exists a strong desire to pass of as a member of the opposite sex. It should be noted that “this cross gender identification must not merely be a desire for any perceived cultural advantages of being of the other sex,” but is the exhibition of a real identity crisis where such an inpidual goes ahead to act , behave and even dress like the member of a sex that he or she believes to be. Such an inpidual also indicates strong desires and states so that he or she would wish to be treated as a member of the opposite sex. (American Psychiatric Association, 2000)

Secondly, the inpidual suffering from the disorder must have a “marked distress or interpersonal difficulty because of the disturbance” (Wanda k, 2005). Such discomfort may be manifested in the inpidual’s behaviors where boys for example will attest to being disturbed by the presence of male sexual organs in their bodies believing that these organs will eventually disappear. Such inpiduals go ahead to behave like the members of the opposite sex refusing entirely to be associated with tools that society has transcribed to be for a certain sex, such as toys and clothes. Girls for example may not be willing to conform to their usual urinating position.

As an inpidual progresses in age, he or she may have a disturbing preoccupation with altering his or her sex characteristics to suite those of his or her perceived gender. There maybe hormonal injections or surgery to get rid of some characteristics. The third criterion is that the inpidual should not have a “concurrent physical intersex condition (e.g. partial androgen insensitivity syndrome or Congenital Adrenal Hyperplasia)” (American Psychiatric Association, 2000)

As aforementioned, in Gender Identity Disorder, both boys and girls exhibit behaviors and also the symptoms manifested in adolescent vary from those of young children. It is important to understand that where children suffering from the disorder may only state their wish to be members of the opposite sex, those in their adolescents may go ahead and behave as such and take the initiative of altering their sexual characteristics. Young children may indulge in fantasies of being members of the opposite sex.

For example, boys may secretly wear their mother’s or sister’s clothes as well as carrying out activities that are culturally accepted to be of the opposite sex. Girls suffering from an identity disorder may spend time playing with balls and boy toys while small boys are preoccupied with playing with girl toys and dolls. Such behaviors according to Victoria et al (2007) may “emerge when the person is a child or it may not present itself until the person is adult.”

Most people suffering from Gender Identity Disorder find it hard to interact and socialize with others and most are victims of ostracization. These boys are referred to as sissies and may undergo intense teasing from their peers. Due to these ostracizations, they are at a higher risk of having depression especially as the society is far from accepting such conditions and the urges towards sex change harbored by such inpiduals.

Gender Identity Disorder is still shrouded with controversy especially as most of the people with this disorder do not regard it as a problem fronting the argument that they are simply not conforming to the society’s assigned gender roles.

It should be noted that there is a clear distinction between Gender Identity Disorder and the inability of an inpidual to conform to the gender roles that are culturally set and accepted. One should not be misdiagnosed as having the disorder “unless the full syndrome is present, including marked distress or impairment,” as American Psychiatric Association (2000) points out adding that Gender Identity Disorder “represents a profound disturbance of the inpidual’s sense of identity with regard to maleness and femaleness.”

There are various treatments to the sexual and gender identity disorder. Sex reassignment surgery that results to an inpidual acquiring desired sexual organs like the vagina and the penis has been described as having a number of side effects as most of the inpiduals that have undergone it “complain of inadequate vaginal depth.” More than 30% regret having undergone sex re-assignment surgery.” (Wanda k, 2005). Other inpiduals resort to hormonal treatment.

Psychotherapy is the most lauded of the efforts to treat Gender Identity Disorder. Such therapy “assist them to find a workable, comfortable sexual identity.” This is in the understanding of the rail road of problems undergone by such inpiduals in a society that views the disorder with stigma lenses. Medical professionals have frowned at conversion therapies believing that such inpiduals should instead be assisted to carry on with the identity they feel comfortable in.

The research into the Sexual and Gender Identity Disorder has undergone tremendous transformations over time but still there exists conflicting details on its diagnosis and treatment. Contributions into the subject are varied but it is important to point out that the works of Richard Green in 1987 titled The Sissy Boy Syndrome achieved much prominence. Earlier studies did not make a distinction between inpiduals with Gender Identity Disorder and homosexuals with Richard green believing they were indeed homosexuals. Past research also did not make a clear distinction between transvestism and transexuality lumping it together with homosexuality. It is only in the recent past that these terms have been well defined giving indications that even transsexuals have own sexual orientation and may necessarily not be homosexuals.

The current research and interests are focused on the best therauptic treatment of Gender Identity Disorder. Findings and experiences indicate that there are successes in treating children suffering from Gender Identity Disorder but it is exceptionally hard to treat adults. Current research also focuses on the follow up on the said treated children to reveal whether the disorder will recur in the later life especially during the late adolescence (Victoria J. et al, 2007)

Gender identity disorder has overtime aroused interest amongst psychologists most of whom feel that it is has been misdiagnosed for long. There exists various models that have been formulated providing varied criteria for its diagnosis. According to the American Psychiatric Association DSM-IV, for a person to be diagnosed with gender identity disorder, he or she must exhibit a strong desire to be identified as a member of the opposite sex. Such an inpidual must also exhibit open distress and disturbance by the presence of sexual organs in the body and wish that they could change their sex. There are various ways to address this disorder but most medical professionals admit it is harder to treat children compared to adults. Future research will center on ways through which therapy could be successfully extended to adults.